Substance Use Disorders
Appendix D
SECTIONS
Components of a Relapse Prevention Agreement
A Relapse Prevention Agreement may include:
- Total abstinence from all abused substances including alcohol;
- Total abstinence from tobacco may improve other substnace-related outcomes;
- Attendance at counseling with a substance use disorder clinician;
- Reporting arrangements to the police physician;
- Regular attendance at support programs such as Alcoholics Anonymous, Narcotics Anonymous, Al-Anon, or Rational Recovery;
- Compliance with treatment for medical or psychiatric co-morbidity;
- Attendance at regularly scheduled monitoring visits, which may include scheduled face-to-face visits with a clinician to provide support, screening for impending relapse, and reviewing compliance with treatment;
- Participation in agency-mandated substance testing to verify abstinence; and
- Acknowledgement of consequences of non-adherence.
See Appendix H for a sample Relapse Prevention Agreement.